Study On The Correlation Between TCM Syndromes And Brain-gut Peptide Of Diarrhea-predominant Irritable Bowel Syndrome Overlap Gastroesophageal Reflux Disease

Irritable bowel syndrome(IBS)and gastroesophagous reflux disease(GERD)are two common diseases in the digestive system.A large number of epidemiological studies at home and abroad have shown that these two diseases have a high incidence,and the symptoms are prone to overlap.GERD patients often have IBS diarrhea and some parenteral symptoms in IBS are GERD typical performance.The common etiology between two diseases may be genetic,psychological factors,hormones,non-steroidal anti-inflammatory drugs and biliary diseases.The common pathophysiological mechanism may be visceral paresthesia,gastrointestinal abnormalities and neurological dysfunction.TCM thinks that the "gas" is essential to the normal activities of the human body.Spleen and stomach movements dysfunction occurs acid reflux,hiccups.Liver links with intestinal tract and poor intestinal gas occurs diarrhea.Both diseases are closely related to the "gas".In this study,using patients of D-IBS overlapping GERD as the research objects,using pure D-IBS,GERD patients and healthy people as control group.The general situation,diet and morbidity of the patients are investigated by clinical questionnaire.Ghrelin,leptin,calcitonin gene-related peptide(CGRP)and neuropeptide Y(NPY)in plasma are measured by enzyme-linked immunosorbent assay(ELISA)in part of the patients.The results are as follows:1.Patients of D-IBS overlap GERD have a relationship with the of course of disease:In 120 cases of patients of more than five years have the highest proportion is 67 cases(55.8%),they are statistically significant compared with the pure D-IBS and GERD group(P<0.05).2.The different TCM syndrome types of overlapping patients are related to the endoscopic performance:In 120 cases of overlapping patients,the proportion of D-IBS overlap NERD patients with liver qi and spleen syndrome are significantly higher than those of patients with D-IBS overlap RE(?<0.05).3.Patients of D-IBS overlap NERD have more serious gastrointestinal symptoms:D-IBS overlap NERD patients' symptom score are significantly higher than those patients with D-IBS overlap RE,the difference is statistically significant(P<0.05).4.There are many abnormal levels of brain gut peptide in overlapping patients:Compared with the healthy group,the level of ghrelin in plasma is significantly lower(P<0.05),the level of Leptin and CGRP is significantly higher(P<0.05);The level of NPY and Leptin is significantly decrease(P<0.05,P<0.01).The level of CGRP in plasma increase significantly(P<0.01);The level of Ghrelin in plasma of GERD patients decrease significantly(P<0.05),the level of Leptin and CGRP increase significantly(P<0.05).5.The performance of esophageal endoscopy in overlapping patients are related to the level of CGRP in plasma:compared to the patients D-IBS overlap NERD,the level of CGRP is significantly lower in patients than those of D-IBS overlap RE(P<0.05).6.The level of Leptin,NPY and CGRP have a relationship with TCM syndromes:In 80 cases of overlapping patients,the level of Leptin by liver and spleen deficiency syndrome is significantly higher than that in the inverse gas group,the difference is statistically significant(P<0.05).The level of NPY and CGRP by liver stagnation and spleen deficiency of serum is significantly higher than that of spleen and stomach group,the difference is statistically significant(P<0.05).Conclusion:The course of disease in D-IBS overlap GERD patients is easy to procrastinate;the level of Leptin,NPY and CGRP has related to the different TCM syndromes;TCM syndromes in liver spleen has the highest incidence;the level of Leptin,NPY and CGRP in plasma has related to the difference of TCM syndrome types.